Blog

All of the following clinical circumstances increase caloric requirements except:

Postoperative concerns in the child undergoing cardiac surgery  include airway, hemodynamics and function. The PNP remembers that cardiac output is determined in the child by the following:

All of the following are scored in the Pediatric Glasgow Coma Scale except:

You are called for a stab wound to the chest. The patient is a 19 yo M who has a radial pulse, but no obtainable blood pressure. He is anxious and gasping for air.  On auscultation he has absent breath sounds on one side and you observe distended neck veins, & tracheal deviation. His CXR is below.    What is the most appropriate first step in management of shock in this patient?  

A 4 year old female presents to the ED after swallowing a penny. The X-ray reveals the coin to be in the stomach. What is the next most appropriate step in management?

 Which of the following substances is associated with pupillary constriction?  

A 6-year old boy presents to the emergency department due to progressive difficulty walking over the past 1–2 days. His parents report that his eyes have appeared “crossed” several times recently.  His parents first noticed that he was having difficulty keeping up with his karate class this past month, and his smile is less symmetrical than usual. On physical exam, there is noted slurring of his speech. Hemifacial droop, along with a marked cranial nerve 6th nerve palsy, is noted. Which of the following diagnoses is most likely?

You are consulting Peds Neurology for a 6 week old patient who presented to the pediatric floor with severe hypotonia and poor feeding. His birth history reveals an uncomplicated pregnancy and normal birth. His birth weight was 2500 g at 39 weeks GA. His APGAR scores were 8 and 9. On exam, he has a wide nasal bridge, low set ears, upturned nose, micrognathia, and a sacral dimple. Neuro exam reveals severe hypotonia with normal spontaneous movements and deep tendon reflexes. The metabolic newborn screen was normal. The head ultrasound shows a smooth cortex with mild ventriculomegaly. Which is the most appropriate next test in order to make the most appropriate diagnosis?

A 4 year old male is your patient in the PICU. He is s/p repair of his congenital heart defect. During your exam this morning, you notice that he now has new onset of right sided hemiparesis. His speech is difficult to understand, even for his mother. Which one of the following image modalities would be the most appropriate for the initial evaluation of this patient?  

A 13-year-old male presents with a 24-hour history of sharp, pleuritic chest pain that is worse in the supine position. He recently had a viral illness a few weeks ago. Now has a fever at 38.5 C and a pericardial friction rub is heard on exam. The most likely diagnosis is: